A pay-for-performance system for civil service doctors : the Indonesian experiment.

In this paper we evaluate how well the system-which in principle could be applicable to both developed and developing economies-can meet its stated objectives for Indonesian doctors working in the community, and for Indonesian health policy objectives as stated in the country's last five-year development plan « Repelita V » (Government of Indonesia.

The Fifth Five-year Development Plan (Repelita V) 1989-1994.

Jakarta, Indonesia, 1989).

The FPS is particularly innovative in the Indonesian environment where wages are low and comparatively uniform, reflecting a philosophy of'shared poverty'and vary primarily by seniority.

The FPS has, however, several conceptual and practical shortcomings.

The design of the reward system disregards effort or time inputs, as well as other inputs needed per unit of reward.

Consequently, the FPS can not be used as an effective incentive system promoting professional excellence and health policy objectives.

Practically, the system hardly provides an effective alternative for career development among community physicians.

Nor does the system provide enough resources to induce physicians to spend more effort in their civil service activity and less effort in private practice.